WINTER, FEBRUARY 2017
VOL 16 • NO 1
SUPPORTING THE HUMAN RIGHT TO A DEATH WITH DIGNITY
www.finalexitnetwork.org- Easily renew your membership online!
Being Mortal:
What is the
Physician’s
Role?
By Don Gaede, MD
The heart asks pleasure first,
And then, excuse from pain;
And then, those little anodynes
That deaden suffering;
And then, to go to sleep;
And then, if it should be
The will of its Inquisitor,
The liberty to die.
— Emily Dickinson
T
he early morning phone call jarred him into consciousness. “Bill, my dad just killed himself. I just
found his body in the garage.”
Bill is my friend. His wife was visiting her parents, helping them cope with her father’s advanced bladder cancer.
The oncologist had just told him that the chemotherapy was
not helping, and that surgery was not an option.
The next day, her father’s mood changed. He appeared
to have given up all hope. For dinner, he asked for his favorite meal of kung pao chicken. Later that evening, he said
almost casually to his wife, “We’ve had a pretty good life
together, haven’t we?” In the wee hours of the next morning,
he slipped out of bed and put a bullet through his head.
Her father was an 83-year-old veteran of the Vietnam and
Korean wars, a highly-decorated colonel, a “take-charge”
kind of a guy. But before ending his life, he did not take the
time to say goodbye to his wife and children. And he left a
long wake of shock and sorrow behind him.
PHYSICIAN continued on page 3
CONTENTS
DESMOND TUTU .................. 2
MN DECISION GOES
TO HIGHER COURT ............... 4
OHIO .................................. 7
CALIFORNIA EOL ACT........... 8
THE END ............................ 10
By Archbishop Emeritus
Desmond Tutu, Nobel Prize Winner
“When my
time comes,
I want the
option of
an assisted
death”
Desmond Tutu is archbishop emeritus of Cape Town, a Nobel
Peace laureate, and one of the world’s most respected religious
leaders. This opinion was published in the Washington Post on October 6, 2016.
T
hroughout my life, I have been fortunate to have spent
my time working for dignity for the living. I have campaigned passionately for people in my country and the
world over to have their God-given rights.
Now, as I turn 85 Friday, with my life closer to its end than its
beginning, I wish to help give people dignity in dying. Just as I
have argued firmly for compassion and fairness in life, I believe that
terminally ill people should be treated with the same compassion
and fairness when it comes to their deaths. Dying people should
have the right to choose how and when they leave Mother Earth. I
believe that, alongside the wonderful palliative care that exists, their
choices should include a dignified assisted death.
There have been promising developments as of late in California
and Canada, where the law now allows assisted dying for terminally
ill people, but there are still many thousands of dying people across
the world who are denied their right to die with dignity. Two years
ago, I announced the reversal of my lifelong opposition to assisted
dying in an op-ed in the Guardian. But I was more ambiguous
about whether I personally wanted the option, writing: “I would say
I wouldn’t mind.” Today, I myself am even closer to the departures
hall than arrivals, so to speak, and my thoughts turn to how I would
like to be treated when the time comes. Now more than ever, I feel
compelled to lend my voice to this cause.
I believe in the sanctity of life. I know that we will all die and
that death is a part of life. Terminally ill people have control over
their lives, so why should they be refused control over their deaths?
Why are so many instead forced to endure terrible pain and suffering against their wishes?
I have prepared for my death and have made it clear that I do not
wish to be kept alive at all costs. I hope I am treated with compassion and allowed to pass on to the next phase of life’s journey in the
manner of my choice.
Regardless of what you might choose for yourself, why should
you deny others the right to make this choice? For those suffering
unbearably and coming to the end of their lives, merely knowing
that an assisted death is open to them can provide immeasurable
comfort.
I welcome anyone who has the courage to say, as a Christian,
that we should give dying people the right to leave this world with
2 Final Exit Network • www.finalexitnetwork.org
Winter Newsletter, February 2017
dignity. My friend Lord Carey, the former archbishop of Canterbury, has passionately argued for an
assisted-dying law in Britain. His initiative has my
blessing and support—as do similar initiatives in my
home country, South Africa, throughout the United
States and across the globe.
In refusing dying people the right to die with dignity, we fail to demonstrate the compassion that lies
at the heart of Christian values. I pray that politicians,
lawmakers and religious leaders have the courage to
support the choices terminally ill citizens make in
departing Mother Earth. The time to act is now.
Words of Wisdom
When the burden of life begins to
outweigh that life itself, is one really
living? And when the cold of death
brings a close to the overbearing
burden, is one really dying?
Brian K. Collier
Sadly, many doctors seem to
consider death a curable disease.
Paula Gold Chalef, JD
I’d rather die while I’m living than
live while I’m dead.
Jimmy Buffett in
“Growing Older But Not Up”
The more we can freely discuss
a variety of personal options, the
more likely we can move towards a
more humane response to end-of-life
decisions.
Anton S. Wallner, PhD
Death is not the worst thing; rather,
when one who craves death cannot
attain even that wish.
Sophocles (?496-406 BCE)
spoken by Chrysothemis in Electra
WISDOM continued on page 14
Winter Newsletter, February 2017
PHYSICIAN continued from page 1
Since that day three years ago, my friend and
his wife have often wondered how things might
have gone differently. Would a palliative care
consultation have averted his decision? If there
had been a physician aid-in-dying law, could he
have ended his life without causing so much emotional trauma to his family?
Atul Gawande, author of the best-selling “Being Mortal,” has cited a 2010 Harvard study in
which half of the lung cancer patients received
early palliative care. This intervention led to significant improvements in both quality of life and
mood. As compared with patients getting standard care, patients receiving palliative care had
less aggressive treatment at the end of life, but
surprisingly, longer survival.
Palliative care is often confused with hospice.
That’s understandable, because it’s an important
component of hospice care. But while hospice
offers comfort during the last months of life,
palliative care can be given at any point in a serious illness, and can be given along with curative
treatment. Gawande believes that a palliative care
consultation can be key to helping people with
terminal illness live the last days of their lives
with better quality.
An editorial in the Journal of the American
Medical Association entitled “The Liberty to
Die” by Drs. Adashi and Clodfelter, described the
controversy well: “To its proponents, physician
aid-in-dying represents compassion and beneficence in the face of terminal physical pain and
disability, and the right to exercise free choice
and autonomy of will. To its opponents, physician aid-in-dying violates deeply held views on
the sanctity of life, distorts the imperative of the
healing mission, devalues the role of palliation,
and risks coercion of the elderly, disabled, destitute, and despondent.”
I have a lot to learn about end-of-life issues.
Depending on the situation, and after a palliative
care consultation, I might consider assisting a
patient in ending his or her life. But however we
physicians feel, we need to become more familiar
with this difficult topic, turn it over in our minds,
discuss it among ourselves, and most importantly,
listen carefully to our patients’ concerns.
Final Exit Network • www.finalexitnetwork.org 3
I
Appeals
Court Claims
No Authority to
Overturn Ruling
n a legal case testing whether Final Exit
Network is allowed to teach about selfdeliverance, the Court of Appeals of Minnesota has upheld FEN’s 2015 conviction for “assisting” in a “suicide.”
Final Exit Network, Inc.—the corporation only,
not any individual—was found guilty in 2015 of a
felony, “assisting” in a “suicide,” and appealed for
the Court of Appeals to reverse the conviction.
“This court was just one step on the appellate
ladder,” said the Network’s president, Janis Landis.
“Whether we won or lost in this court, we always
knew the case would have to go to the Supreme
Court of Minnesota, and maybe beyond. So now
we’ll step up to the next court. We’re in this to stay
until we obtain justice.”
The evidence at the trial showed that Exit
Guides and other Network personnel gave information and support to the decedent, Doreen Dunn. The
evidence showed the Network volunteers provided
no physical assistance in Ms. Dunn’s death in 2007,
but only exercised their First Amendment-protected
right to freedom of speech.
The jury was instructed that it was required to
convict the corporation if its personnel gave Ms.
Dunn instructions about how to terminate her suffering. “Once that jury instruction was given, we
had little or no hope of being found ‘not guilty’ by
the jury,” said Robert Rivas, the Network’s general
counsel.
The trouble for the Network in the trial court
and the Court of Appeals stemmed from an unrelated case in which the Supreme Court of Minnesota
held that one could be convicted of “assisting” in
a “suicide” for communicating “words” that “enabled” a “suicide.”
4 Final Exit Network • www.finalexitnetwork.org
Minnesota
Decision to Go
to Higher Court
“The State of Minnesota is saying we
are committing a crime in Minnesota
for doing exactly what we openly,
proudly, and publicly say we are
doing all over America—giving our
members information, education,
counseling, and emotional support.”
— Janis Landis,
President, Final Exit Network
Winter Newsletter, February 2017
F
By Robert Rivas, Final Exit Network
General Counsel
inal Exit Network has filed a petition for
the Supreme Court of Minnesota to review
a decision, made by two lower Minnesota
courts, that it is a crime in Minnesota to give someone
information about self-deliverance.
The petition for review was filed in January. The
Supreme Court of Minnesota must decide by midMarch whether to hear the appeal.
If the Supreme Court of Minnesota accepts the
appeal, the process will take about a year. If not,
Final Exit Network will then file a petition for the
Supreme Court of the United States to review Minnesota’s new version of the law.
As the law now stands, Minnesota is the only
place in the country where a person will be convicted of the crime of “assisting” in a “suicide” without actually “assisting” at all. Final Exit Network,
Inc.—and only the corporation—was convicted in
May 2015 for giving information to a member about
the helium hood method of terminating her suffering.
Doreen Dunn, 57, of Apple Valley, Minnesota,
had endured unrelenting, excruciating pain from a
spinal injury since 1996. Her doctors saw no prospect of relief. At the time she chose to die on May 30,
2007, she was sure she would soon be warehoused in
a nursing home.
On December 19, 2016, the intermediate Court of
Appeals of Minnesota affirmed the Network’s conviction. In its decision, the Court of Appeals frankly
acknowledged that the Network’s Exit Guides did not
“assist” in the “suicide,” neither by committing any
tangible act of physical assistance nor by providing
Mrs. Dunn with her exit hood, helium tank, or any
other implement used in her final exit.
Said the Network’s president, Janis Landis: “The
State of Minnesota is saying we are committing a
crime in Minnesota for doing exactly what we openly, proudly, and publicly say we are doing all over
America—giving our members information, education, counseling, and emotional support.
“We will not accept the Minnesota’s absurd new
law because we cannot live with it. This precedent
threatens Final Exit Network’s very existence.”
The Network’s attorney, Robert Rivas, said the
Network recognizes that there are limits on the right
Winter Newsletter,
Newsletter, February
February 2017
2017
Winter
to free speech. “But the Minnesota rule is unlike any
of the recognized American exceptions to the right to
free speech,” he said.
“Under the Minnesota rule, if your loved one is
contemplating the termination of her suffering, and
you email her a hot link to a URL where she can buy
an instant download of a copy of Derek Humphry’s
book, Final Exit, you have committed a felony. This
simply cannot be the law.”
The trouble for the Network in the trial court and
the Court of Appeals stemmed from an unrelated
case involving a nurse from Faribault, Minnesota
named William Francis Melchert-Dinkel. In his case,
the Supreme Court of Minnesota held in 2014 that
one could be convicted of “assisting” in a “suicide”
for communicating “words” that “enabled” a “suicide.”
In its 18-page opinion, the Court of Appeals held
that the trial court’s jury instruction was properly
based on the precedent established in the MelchertDinkel decision. The Court of Appeals repeatedly said it had no authority to overrule the Supreme
Court of Minnesota. Therefore, the court held, it was
compelled to affirm the corporation’s conviction.
The trial court last year sentenced the corporation
to pay the maximum $33,000 fine. Though a conviction for “assisting” in a “suicide” could carry a 15year prison sentence for an individual, nobody could
receive a prison sentence because only the corporation was tried and convicted.
Originally, the corporation and four individuals
were indicted in 2012. All the charges against one
defendant, former Network president Thomas E.
(“Ted”) Goodwin, were dismissed early on. Defendant and former Network president, Jerry Dincin,
died, as did another defendant, former Network
medical director Dr. Lawrence Egbert.
That left only former Network case coordinator
Roberta Massey as a defendant. She was excused
from the trial in 2015 for health reasons, but the
charge remained pending against her. Late in 2016,
in order to make the case go away, she reached a plea
agreement with the State in which she will plead
guilty to a misdemeanor and serve probation in order
to close the case.
Final Exit
Exit Network
Network •• www.finalexitnetwork.org
www.finalexitnetwork.org 5
5
Final
P E R S P E C T I V E
Poll Shows Surprisingly Broad Support for
Medical Aid in Dying in Minnesota
Greenberg Quinlan Rosner Research
Much like support for a legal option itself, support for candidates with this
position extends across demographic, religious and partisan lines.
A
new survey among likely voters in
Minnesota finds broad and deep
support for medical aid in dying. In
principle, Minnesotans believe medical aid in
dying should be a legal option for terminally ill
individuals by a margin of 53 points, 73 percent
– 20 percent, including 55 percent who strongly
believe so.
A similar share of the electorate, 73 percent
(49 percent strongly), supports legislation that
would make that option available for people who
are over the age of 18, terminally ill and deemed
mentally capable by medical experts.
Greenberg Quinlan Rosner Research conducted a survey of 509 likely 2016 general election voters in Minnesota from August 29 - September 1, 2016. The survey [funded by Compas-
6 Final Exit Network • www.finalexitnetwork.org
sion and Choices] had a margin of error of +/- 4.3
percent.
The breadth of the support for this legislation
is striking. There is bi-partisan support for this
legislation and support across generations, geography and religious faiths.
Finally, the survey also found that 61 percent
of voters would be more likely to support a candidate who supports legislation providing a legal
option for medical aid in dying while just 21 percent would oppose a candidate who does. Much
like support for a legal option itself, support for
candidates with this position extends across demographic, religious and partisan lines.
Note: As Derek Humphry has commented, these
figures come from “a state where earlier this year
the Final Exit Network was fined $30,000 for providing guidance to a dying woman!”
Winter Newsletter, February 2017
Ohio Law
“Not so Bad”
T
he Ohio General Assembly has passed a
ticipating in a physical act by which the other person
bill making it a crime to “assist suicide,”
commits or attempts to commit suicide.”
By defining the crime to include only instances in
and Governor John Kasich signed the bill
into law in December, making Ohio the forty-first
which a defendant provides “the physical means,” or
participates in “a physical act,” this statute unequivostate in the Union to criminalize “assisting” in a
“suicide.”
cally prohibits a conviction for speech alone. It is
very much like the statute the chastened and cautious
Until now, the State of Ohio had no statutory law
Georgia legislature enacted after Final Exit Network
making it a crime to “aid” or “assist” in a suicide. But
the Republican-controlled General
got the Georgia law stricken down as
Assembly’s bill now makes “assistunconstitutional in 2013.
Note that the first sentence of the
ing suicide” a third-degree felony.
”Investigators and prosOhio law creates a requirement that,
Interestingly, the new Ohio provision
ecutors are not likely to
in any prosecution, the state prove beagainst assisting in a suicide was just
bring a charge under
a very small part of a larger bill inyond a reasonable doubt that the defentended to enhance the availability of
dant “knowingly caused” the suicide.
the Ohio statute in the
In light of this sentence, “causation”
palliative care.
case
of
an
Exit
Guideis a discrete, additional fact the State
“Compared to other statutes
must prove to a jury beyond a reasonagainst ‘assisting in a suicide,’ the
supported death. For us,
Ohio law is not so bad,” said the
able doubt in Ohio (in addition to the
Ohio is one of the safest
Network’s general counsel, Robfact that the defendant either provided
states in the country.”
the physical means or performed a
ert Rivas. “The way it is worded,
physical act).
it makes perfectly clear that Exit
The mere giving of information
Guides could not be convicted of a
crime for performing Exit Guide services in accordoes not the “cause” the suicide (by making it posdance with the Network’s protocols.”
sible), just as a bridge does not “cause” anyone to get
to the other side of the river (by making it possible).
Exit Guides from Final Exit Network provide
Proof of a decedent’s long-planned, determined, well
carefully screened members with information, edujustified intention to terminate her suffering would
cation, counseling, and emotional support in their
choice to terminate intolerable suffering. In order to
appear to prove a defendant’s innocence in that the
accused did not “cause” the death.
comply with most laws against “assisting” in a “suicide,” Exit Guides are careful not to perform any act
“Investigators and prosecutors are not likely to
bring a charge under the Ohio statute in the case of
of hands-on assistance and not to supply the means.
an Exit Guide-supported death. For us, Ohio is one
The Ohio law says “no person shall knowingly
cause another person to commit or attempt to commit
of the safest states in the country,” the Network’s attorney said.
suicide by doing either of the following: (1) Providing the physical means by which the other person
commits or attempts to commit suicide; [or] (2) Par-
Winter
Winter Newsletter,
Newsletter, February
February 2017
2017
Final
Final Exit
Exit Network
Network •• www.finalexitnetwork.org
www.finalexitnetwork.org 77
E N D
O F
L I F E
O P T I O N
S T A T U T E S
California DWD Law is No Slam-Dunk
By Huck DeVenzio, Newsletter Editor
I
t’s more like a foul shot in pregame
warmup.
Advocates of death with dignity were
understandably elated when California enacted
its end-of-life options bill. After all, California is
a populous, trend-setting state, and it became the
fourth state to pass such a law.
But, a year after the bill was made law, the
fog of euphoria has dissipated and reality has revealed that the emperor isn’t fully clothed.
First, many people likely to use the law to
curtail their suffering are ineligible. People with
slow-progressing degenerative diseases, by the
time they reach the mandatory six-months-tolive prognosis, are often mentally or physically
unable to meet the conditions required for hastening their deaths. Either they are considered mentally incompetent to make this crucial decision or
they can no longer take the necessary steps on
their own.
Jacie Rowe, FEN representative in California,
reported an experience after a presentation. An
attendee broke down in tears when she realized
that there was no way she could legally help her
suffering loved one, despite the law.
Second, a large number of California institutions are choosing not to get involved in DWD
cases. They will neither permit their staffs to
discuss PAD as an end-of-life option nor sign
off on assessments or prescriptions for potential
deaths. Some pharmacies won’t fill prescriptions.
Linda Van Zandt, in a Los Angeles Times op-ed
column, wrote of her difficulty in finding two
doctors to verify the condition of her dying aunt.
“We had been forced to assist in the most bizarre
fashion, jumping through seemingly random legal hoops and meeting arbitrary deadlines while
my aunt suffered, and finally emptying capsules,
making an elixir so vile I cried when I knew she
8 Final Exit Network • www.finalexitnetwork.org
had to drink it. This was death with dignity?”
Rowe says the PAD laws are unlike anti-discrimination laws, “The law permits aid in dying,
but doctors and hospitals can opt out. Imagine
if civil rights laws of the past allowed people to
choose not to follow them. If you do not live in
Sacramento, the Bay Area, parts of Los Angeles,
or San Diego, you may not be able to get two doctors to sign the forms.”
As Tracy Seipel wrote for the Bay Area News
Group, “It’s a scene being played out throughout
California, as scores of terminally ill patients are
learning to their dismay—and outrage—that the
state’s new aid-in-dying law comes with no guarantee of finding a doctor.”
This may change with time as comfort levels
improve. In Oregon in 2000, only 22 doctors were
known by the Oregon Public Health Division to
be prescribing end-of-life medicines. By 2015 the
number had grown nearly five-fold.
Another problem is economic. Since passage
of the bill, the price of the prescription barbiturates has soared from about $125 five years ago to
over $3500 today. They are now out of the reach
of many Californians.
Yet another impediment, certainly not limited to California, has been the lingering stigma
against taking your own life, even to relieve suffering. Jacie Rowe said, “Many people are interested in a peaceful death with dignity and attend
our presentations, but I have heard of many others who do not attend because they fear that their
loved ones would not understand or agree. I think
we would be better served with a return to the
past acceptance of death as unavoidable.”
Meantime, Final Exit Network can shorten
needless suffering and undesired prolongation by
offering a compassionate option. It may not be a
slam-dunk, but it’s worth points.
Winter Newsletter, February 2017
E N D
O F
L I F E
O P T I O N
S T A T U T E S
Is Half a Loaf Better than None?
By Janis Landis, President, Final Exit Network
cases for answering that question. They are small
populations, and from the law’s passage had local
and effective organizations that have continued to
monitor and guide implementation. And, perhaps
most importantly, their laws were introduced
before the current wave of medical practice consolidation. This means that individual physicians
f we have learned anything from the pascould make their own determination about opting
sage of civil rights laws, it is that they
in or out and over time; as opposition decreased,
mean very little without enforcement
more physicians could choose to join. But in
and monitoring. It is gratifying to see Death
California, we are seeing a completely different
with Dignity legislation gaining momentum
dynamic: Large medical practices
around the country. But as with
are making decisions at the Execuminority rights, women’s equalOur mission is to advise
tive level, opting out and requiring
ity, and abortion—it is all about
and comfort suffering
all their physicians to comply with
access. If you can’t obtain the
people who wish to hasthat decision. Second, and equally
benefit, then the law is worse
ten their deaths. Such
critical, no local organization is in
than useless: it promotes a feelservice
is
benefi
cial
place to provide guidance to local
ing of “our work is done” when
whether or not a state
patients seeking to use the law.
the reality could not be further
Compassion and Choices deserves
from the truth. And so it is with
permits PAD. It may
the credit and thanks they have rethe right to die campaign.
even be more valuable
ceived for getting the law passed.
Final Exit Network is not a
in states allowing physiBut upon that law’s passage, C&C
lobbying organization. Our miscian assistance.
closed its volunteer/advocacy netsion is to advise and comfort sufwork. At best, individuals there
fering people who wish to hasten
can call the C&C toll-free line, but there is no
their deaths. Such service is beneficial whether
information available on participating physicians.
or not a state permits PAD. It may even be more
FEN, with our much more limited resources, is
valuable in states allowing physician assistance.
working to fill the gap. We have hired a former
Each state that has approved legislation or a
C&C advocate to continue networking and getreferendum—or even introduced them—has folting the word out. We have made contact with
lowed one and only one model: the Oregon law.
the few courageous doctors who have announced
All these years later, and not one change has been
their determination to provide physician aid in
made. On the surface, there is good reason for
dying within the parameters of the law. And
this: Oregon’s experience has been thoroughly
of course our own toll-free line is available, as
studied and no abuses have come to light, no
always, to answer questions coming from anyscary incidents of coercion, nothing to detract
where in the country—there is no membership
from the “success” story. But what is not asked
requirement and no charge for this service.
is: has it in fact served its purpose?
Oregon and Washington were not good test
HALF A LOAF continued on page 10
More jurisdictions are accepting physicianassisted death (PAD). What does this mean for
Final Exit Network? Are we becoming less relevant, or more? FEN President Janis Landis addresses these questions
I
Winter Newsletter, February 2017
Final Exit Network • www.finalexitnetwork.org 9
HALF A LOAF
continued from page 9
And so with the hoped-for expansion of PAD laws, the need for our
services will be even greater. And
of course, our original mission, providing information to those seeking
end-of-life options remains urgent. As
you know, all the PAD laws require a
prognosis of death within six months.
Those suffering the most, from neurological diseases such as ALS and
Parkinson’s will find no relief under
those laws. And it is particularly cruel
We are the only organization
that provides the missing half
of the loaf. Without it, the law
remains, for most, a cruel illusion, inapplicable and/or out
of reach when people actually seek to use it.
The End
for them because the congratulations
and celebrations upon the law’s passage have raised hopes which are then
dashed when the strict limitations of
the law are made clear. We remain the
only DWD organization in the United
States providing information to these
desperate individuals.
So is there a place for FEN in
the wake of more PAD laws? If we
want these laws to have practical
meaning, if we want to encourage
improvements in the existing legislative template and if we want to
reach those excluded by the law, the
answer is a resounding YES. We are
the only organization that provides
the missing half of the loaf. Without
it, the law remains, for most, a cruel
illusion, inapplicable and/or out of
reach when people actually seek to
use it.
10 Final Exit Network • www.finalexitnetwork.org
By Nontheist
Condensed from a story published in
The Humanist magazine
Winter Newsletter, February 2017
W
e sat hip to hip on the family room sofa that day holding hands,
my husband and I. Dawn had barely grazed the horizon when
our son, almost daughter, and niece joined us. I don’t remember what or if
we ate. I do know coffee and tea were made and gulped, and we talked of
the distances loved ones had traveled to join us.
When my husband (I’ll call him John) got up to
put empty cups into the dishwasher, someone
said, “You shouldn’t be doing that.” He answered,
“I want this day to be as normal as possible.”
We were with him because he didn’t want to die
alone, and this was the day my husband had chosen to die.
That morning he went on his customary threeand-a-half-mile walk, taken with a cheat sheet in
his hand listing the street names and turns so he
could return home safely. He would take his own
life just hours later, but he insisted on following
his routine. His bravery cannot be disputed.
That final day had been a long time coming.
John was a scientist—a health physicist who loved
to educate others about radiation safety. He was a
world traveler, a skydiver, a hiker, a reader, and
a man who never passed a museum without going in. Now he had Alzheimer’s. His father, his
grandmother, and his uncle had all had it.
One day, approaching his sixty-eighth birthday, John told me he was worried. My modest,
kind, and loving husband acknowledged what I
had already seen for two years. His short-term
memory was going. The disease could eventually
lead to loss of speech, an inability to eat or walk
unaided, a complete oblivion of the man he had
been. In time he would not even recognize me.
The day we both faced the inevitable, we
gazed at one another with tears in our eyes. He
took a deep breath and then told me that when he
could no longer follow his intellectual pursuits,
when he could no longer drive legally, when he
was not yet incontinent or blaming me for his own
inabilities, he would take his own life.
Alzheimer’s is a slow-developing disease, and
we’d had several years that were only occasionally
interrupted by his behaving in ways unacceptable
to both of us. In the meantime I’d been putting
out feelers to family and selected friends. What
did they think of suicide as an eventual answer to
our problem? Some couldn’t believe there was a
problem. John was far too intelligent and logical
for that, they said. Others talked vaguely of getting in trouble with the law. Few knew anything
about death with dignity.
By now we were members of the Final Exit
Network. I wrote to Final Exit to ask if he was a
candidate. They said he came under the parameters of people they counseled about self-delivery.
That year stomped into our lives a full ten
years after I’d first noticed what I considered
illogical thinking by my very logical husband.
Now, John told me he was making too many errors, even forgetting important events. It was time
for the end.
With Alzheimer’s there is a small window of
opportunity, so to speak. A patient who admits
their problem, although memory-impaired, can
still understand his or her difficulties. A month
or two later, the same person might not understand. He or she might even think there’s nothing
wrong. At one point John and I had gone to the
movies. John left after the beginning to go to the
men’s room, but he couldn’t find his way back.
He couldn’t remember the name of the movie nor
the number of the theater in the complex. He tried
unsuccessfully to find me. But he still understood
what was happening. Consequently, he waited in
the lobby until I found him. A little later in the
JOHN continued on page 12
Winter Newsletter, February 2017
Final Exit Network • www.finalexitnetwork.org 11
JOHN continued from page 11
With Alzheimer’s there is a small
window of opportunity, so to speak.
A patient who admits their problem,
although memory-impaired, can still
understand his or her difficulties.
A month or two later, the same person
might not understand.
progression of his disease, he would not have understood.
Shortly after a few similar episodes, the Final
Exit Network gave me the name of a volunteer in my
home state to contact. This person had me put the
particulars in writing. I also had to include a copy of
John’s last appointment with a neurologist. All that
took time. Afterward someone else from Final Exit
called John and asked multiple questions about his
ability to understand and carry out his own demise.
He had to show verbally that it was his decision and
that he was capable of doing it. He also had to write
a letter to the Final Exit Network stating exactly why
he wanted to end his life. He agreed, but day after day
he forgot about doing it. His forgetfulness had grown.
I had to remind him.
Clinically depressed persons or others in like
circumstances are screened out by Final Exit. John
passed Final Exit’s scrutiny, and a guide, one of the
volunteers who give their time to help others, contacted us. Again we had to state suicide was John’s
decision, but that I agreed. Still, the questioning
continued. Did we have any relatives or friends who
might—for religious or other reasons—want to stop
us? Did we have neighbors who would suddenly
“drop in?” We had to be sure we would not be interrupted on the final day. We assured him nothing like
that would happen. He explained he would have to
12 Final Exit Network • www.finalexitnetwork.org
visit us and go through the arrangements before the
final date, make sure we had all the materials and
understood the procedure.
I called my son. He arrived a week before the final day, and we spent those seven days going places,
doing things, making John’s last days as sweet as
possible. Once we went to an expensive restaurant
and blew the budget. Another time when we were out
for dinner John ordered something omitted from his
heart-healthy diet for years.
That week I suggested John leave a suicide note.
I wanted it clear that I wasn’t in any way coercing
or giving him the kind of assistance that would be
against the law. Again, he kept forgetting, but midweek he typed a short, concise, and perfectly lucid
note.
I don’t remember whether it was fair or freezing
John’s final morning. I do know I felt incredibly close
to him, and he to me. At nine o’clock the guide and
her assistant arrived. Once again we went through
the procedure we would all follow. Once again they
asked if this was what John really wanted to do. Once
again John’s voice rang without hesitation, “It is.”
John made his goodbyes to everyone. There were
hugs and teary eyes, but no one cried, no one protested. I sat next to him on one side of the bed, my
son on the other. The others sat in chairs at the foot
of the bed. John followed the routine he’d practiced.
Then he turned to me and said, “I love you.” I told
him I loved him. We exchanged a look and within
seconds he was unconscious. There was no pain, no
problems. He would never suffer the indignities that
he so abhorred.
In twenty minutes or perhaps a half hour, he
breathed his last. Following the advice of the Final
Exit team, I went with the others to the local mall. We
sat in the food court and tried to appear as if it were
any other day. Two hours after we left home, we were
back. My son “discovered” my husband and called
the local police.
Eight minutes later the first of a parade of police,
emergency medical technicians, and the county sheriff appeared. It was too late for resuscitation. Too
late for anything except a report and notifying the
coroner. It was clear John had taken his own life. In
addition to his suicide note, he had a copy of the book
Final Exit by Derek Humphry on his nightstand.
He will be missed more than he could ever
know.
Winter Newsletter, February 2017
Good Endings Book Club
ed in knowing what steps they can take to best help
themselves get the “good death” we all seek, should
get and read this book.
NOTE: How To Get The Death You Want is not officially out yet but advance copies may be ordered
from the publisher at www.upperaccess.com. By
April it will be available through Amazon and other
book stores.
“Good Endings Book Club” is a compilation of
reviews, ratings, and recommendations (and antirecommendations) on books dealing with end-of-life
issues. If you have read a thought-provoking book,
or read a book you disliked, send your comments to
[email protected]. The Club also welcomes debates and discussions among contributors.
How To Get The Death You Want
By John Abraham
Comment by Janis Landis
John Abraham, below, is FEN’s
affiliate leader in Arizona.
The Arizona affiliate is one of
our most successful affiliate
organizations.
Movie Review:
The Farewell Party
Comment from Jerry Metz, M.D.
“The Farewell Party,” available through Netflix, is a thought-provoking 93-minute drama set in
a retirement home. The film centers on death with
dignity and manages to span the entire spectrum of
viewpoints pro and con. Those who wish to die are
consistently characterized as rational but fireworks
fly as loved ones float an armada of arguments. In
some cases the arguments are entirely internal as
characters who approve in theory lack the ability to
act. The tricky issue of dementia is tackled with tact.
There is just enough wry humor to salt this concoction to taste, making it an appropriate movie to use as
an introduction to the issue, to be followed perhaps
by a panel discussion or a question and answer session by an audience. The sound track is in Hebrew
but English subtitles are well done and benefit the
hard of hearing.
iiiiJohn Abraham has
written a wonderfully inclusive guide to end-of-life
issues. With wit and compassion, he had used his extensive knowledge to provide a comprehensive look
at all sides of this topic. Readers will get an understanding of the philosophical and religious issues as
well as the legal and practical ones. Anyone interestWinter Newsletter, February 2017
Final Exit Network • www.finalexitnetwork.org 13
? Reflections . . .
My Own Choosing
By Renée Neumann
After reading an opinion piece in her local newspaper on the increasing suicide rate among Arizona’s
elderly, Renée wrote to the editors of the Green Valley News who published her reply. Below is part of
her letter. She also offered another reason for the
high rate: Arizona’s elderly are often geographically
removed from loved ones who would object to a suicide decision.
H
asn’t it occurred to you that one of the
reasons for increased self-deliverance
here is the increased publicizing and
acceptance of our final human right? As in more
being said and written about it, and growing numbers of countries and U.S. states legalizing physician aid in dying.
Europeans have a number of organizations campaigning for rational life-ending in old age. That is,
the individual’s right to say, “I’ve lived the life I want
to live, I’m suffering, it’s only going to get worse, and
I choose not to go on.”
It’s not isolation, it’s not a fear of being a burden,
it’s not financial problems, as the article stated.
It is one’s choice that they are already dealing
with enough problems with chronic illnesses that
will only get worse. It is the sense of completion of
having already done what one wants to, and no need
to suffer more, needlessly. And the personal and perfectly legal choice not to put oneself through increasing pain and loss of all the things that give one joy in
life.
No one—no government, no religious organization, no group of any kind, not even family members—has the right to take that choice from you.
We need to stop putting religious, societal, and
other values before our individual happiness, which
is also a constitutional right as well as a human
right.
Europeans view this issue much differently from
Americans. I choose their way because it is more
enlightened, compassionate, and rational in how I
will end my life—barring accident or sudden fatal
illness—by a method and time of my own choosing.
14 Final Exit Network • www.finalexitnetwork.org
Please consider adding Final Exit
Network to your will.
The only information you need is
our Tax ID number, 80-0119137,
and our address is:
Final Exit Network, PO Box 10071,
Tallahassee, FL 32302
WISDOM continued from page 3
We all die. We need not die alone and in
despair.
John Abraham, M. Div.
I know that life is finite and that death is
unavoidable. For me it came down to the
quality of the life I want to live. And come
what may, I think we really hurt ourselves
by trying to just not be dead.
Desiree Basila “on forgoing cancer treatment”
There cannot be a more basic human freedom as personal as ordering the circumstances of one’s death. One should have
the same sense of self-determination when
dying as one expects when living.
Paula Gold Chalef, JD
The option to end one’s life is a personal
decision that must be allowed for all
individuals to make. Trying to enforce
laws that attempt to legislate based on
moral or religious grounds is unfair,
unfounded and not based in any aspect of
scientific fact.
Anton S. Wallner, PhD
Winter Newsletter, February 2017
THE ULTIMATE HUMAN RIGHT OF THE 21st CENTURY
YES! I want to support this important work.
EASY CONTRIBUTION METHOD
1. Mark your check as a membership and/or donation - SAVE the receipt at the bottom of this page.
7
2. Place your check in the supplied envelope, affix your address label, stamp, and drop in the mail!
1
FOR NEW MEMBERS, INFORMATION CHANGE, GIFT, OR CREDIT CARD PAYMENTS:
Affix a label, or if your name is on the label on the reverse side of this page, skip to step 2.
NAME____________________________________________ SPOUSE/PARTNER _____________________________________________________________
ADDRESS____________________________________________________________________________________________________________________
CITY STATE ______________________________________________________ ZIP _____________________________________________________________
________________________________________________
How did you learn about us? ____________________________________________________________________
Do you prefer to receive the newsletter by email? Yes ___ No ___
PHONE______________________________________________________ E-MAIL
2
3
CIRCLE
ONE:
NEW:
INDIVIDUAL $50
COUPLE $75
RENEWAL:
INDIVIDUAL $50
COUPLE $75
CONVERT TO
LIFE MEMBER:
INDIVIDUAL $500
COUPLE $750
YEAR END APPEAL
DONATION
MasterCard
LEGAL DEFENSE $ ____________
TOTAL $ ____________
I am interested in providing an estate
gift to support this worthy cause.
PLEASE HAVE A NETWORK
REPRESENTATIVE CALL ME
7
(Please check type of card)
$ ____________
MEMBERSHIP $ ____________
JOIN/
DONATE
NOW
CREDIT CARD
CHECK
PAYMENT:
LIFE MEMBER:
INDIVIDUAL $500
COUPLE $750
Visa
AmEx
Discover
Credit Card # ________________________________________________
Exp. Date __________________________ CSV _____________________
Signature __________________________________________________
SEND THE PORTION ABOVE THIS LINE WITH YOUR PAYMENT IN THE ENCLOSED ENVELOPE; SAVE PORTION BELOW
FILL IN & KEEP THIS RECEIPT/RENEWAL REMINDER BELOW FOR YOUR RECORDS.
RECEIPT FROM: FINAL EXIT NETWORK, P. O. Box 10071, Tallahassee, Florida 32302
RECEIVED FROM: _______________________________________________________________________________
DATE: ______________________________ DATE TO RENEW NEXT YEAR ________________________________
PAID BY:
PAYMENT FOR:
_____ CREDIT CARD
_____ CHECK: # _____________________
MEMBERSHIP (AMOUNT $_____________
SAVE THIS
RECEIPT
FOR YOUR
RECORDS
DONATION (AMOUNT $_____________
FINAL EXIT NETWORK is a nonprofit 501(c)(3) corporation dedicated to ensuring death with dignity.
Membership and donation processing takes 4-6 weeks. Donations and membership dues are tax-deductible to
the full extent allowed by law. QUESTIONS? 1-866-654-9156
Winter Newsletter, February 2017
Final Exit Network • www.finalexitnetwork.org 15
FINAL EXIT NETWORK
P.O. BOX 10071
TALLAHASSEE, FL 32302
Member Benefit:
U. S. Living Will Registration
Have you registered your living will? It is a benefit available at no charge to FEN members.
The U.S. Living Will Registry (USLWR) is a secure, on-line
database where you can store your advance directive and/or organ donor information. To receive this free benefit, request the
U.S. Living Will Registry form by email at finalexitnetworkcon
[email protected], click the corresponding button on the member
benefits page of the FEN website, or call the Final Exit Network
number 866-654-9156.
To learn more about the USLWR,
visit www.uslivingwillregistry.com.
Our Guiding Principle
Mentally competent adults have a basic human right to end their
lives when they suffer from a fatal or irreversible illness or intractable
pain, when their quality of life is personally unacceptable, and the future
holds only hopelessness and misery. Such a right shall be an individual
choice, including the timing and companion, free of any restrictions by
the law, clergy, medical profession, even friends and relatives no matter
how well-intentioned. We do not encourage anyone to end their life, do
not provide the means to do so, and do not actively assist in a person’s
death. We do, however, support them when medical circumstances warrant their decision.
BOARD MEMBERS
Janis Landis, MA,
President
Kevin Bradley, MDiv.
Cameron Linen, MTS, MS
Judy Snyderman, MBA,
Treasurer
Martin Seidenfeld, PhD
Tom Tuxill, MD
Lee Vizer, MA
Gary Wederspahn, MA
NEWSLETTER STAFF
Huck DeVenzio, Editor
Julia Hanway, MA,
Layout & Design
ADVISORY BOARD
MEMBERS
Linda J. Banez
Schera Chadwick, MA
Ila DeLuca
Huck DeVenzio
Ruth von Fuchs, MA
Faye Girsh, EdD
Rosalie Guttman, PhD
Derek Humphry, Chair
Richard MacDonald, MD
Wendell Stephenson, PhD
President Emeritus
QUESTIONS?
Toll-free: (866) 654-9156
Art credits: Pages 1, Mircea Bezerghoanu;, 2, Komelau; 4, Brandon Bourdages; 7, Qingwaa; 9, Chubphong; 10, Luminis; 12, Ruslan Hayau; 13, Pavlo Syvak; 14, Jaren Wicklund
| © Dreamstime.com.